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Medical oxygen on boats.


Karma Dreams
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Portable oxygen concentrators are available; the ones I've seen are the size of large handbag and have rechargeable batteries.

In my limited experience, they work reasonably well in a boat situation but no doubt you should take advice on the medical suitability.

 

Edited by Tacet
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19 minutes ago, Tacet said:

Portable oxygen concentrators are available; the one's I've seen are the size of large handbag and have rechargeable batteries.

In my limited experience, they work reasonably well in a boat situation but no doubt you should take advice on the medical suitability.

Yes, I saw those listed on that Ebay link I posted. I know nothing about them but was intruiged. 

http://m.ebay.co.uk/itm/181942791297?_mwBanner=1

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12 minutes ago, WotEver said:

Yes, I saw those listed on that Ebay link I posted. I know nothing about them but was intruiged. 

http://m.ebay.co.uk/itm/181942791297?_mwBanner=1

My father had COPD and needed additional oxygen most of the time.  There are mains operated concentrators about the size of a suitcase - which come with a length of plastic hose to allow some mobility.  Whilst this is far from ideal, the large oxygen cylinders are hardly portable so it makes no difference in that respect.

The advantage is the removal of the need to regularly change oxygen cylinders as you only get a couple of days  before needing to exchange the cylinders – and answering the door for a new delivery uses up about half one’s supply.  It also makes a few days away much simpler if you disregard the rule against transporting the machine.  The alternative is to have planned manoeuvres with cylinders bunkered ahead.

The small cylinders that are intended to help you when out and about are either too heavy or too small to be much use.   A portable concentrator  had battery pack(s) and 12v option.   Lugging it around is still a pain – but do-able especially if someone else has the spare batteries.  It also seems to be less risky than having several cylinders of oxygen rolling around a boat.

The portable seemed to work OK – but suspect that it was less robust.

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In order to answer the question we need to know your prescription. It sounds like you need it during walking or exertion and you need 2/3 lpm I am assuming through a nasal cannula. 

 

MGS probably can supply your needs better as their cylinders operate at a higher pressure.

For example: http://www.medicalgassolutions.co.uk/prod/emergency-services-gases/1-litre-carbon-wrap-oxygen    This is a 305 litre capacity which even at your high setting would give 100 minutes. Obviously there are larger cylinders. 

 

BOC's standard cylinder the CD weighs 3.5kgs and contains 460 litres or about 150 minutes supply.

 

The person to see is your long term conditions nurse in the first instance. The aim of the health service is to try and give you a decent quality of life and they are usually happy to prescribe portable cylinders. 

 

An average Emergency Ambulance carries up to 6000 litres of oxygen and is not fitted with any oxygen meter nor have I ever seen one in a patients house. 

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On 05/06/2017 at 15:46, Karma Dreams said:

   But by the look on his face I know he hadn't a clue of what I was explaining about locks and dragging a trolley complete with with oxygen cylinder around with me.b

I'm sure there must be other boaters like me out there, who cope with this condition, and manage their boating with something more manageable?? If so, please help if possible in pointing me in a direction.  As always guys and gals thanks in advance.  

Although I can offer very little experience, I think I can offer some positive support.

Recently I was misdiagnosised with either COPD or sleep apnea, they weren't sure which.  As it turned out, it was neither, thankfully.  

But the doctors were well aware that we live on a canal boat, and as we were discussing my course of treatment and eventually returning home to the boat and what that meant. 

There was discussion about having a portable version of the hospital stats machine installed on the boat along with three forms of oxgen supply; 1 for the bedroom which would supply the NIV mask which would be used while I was sleeping, a tank which would be on a small trolly that I could take with me as I moved about inside the boat whilst hooked up to the nasual feed; and finally a portable canister that fit into a knapsack type holder which they said I could use whilst manning the tiller through locks (Dave would have needed to do the working of the locks, as I would not have been comfortable of crossing the gates with an oxgen filled knapsack on my back and being as light headed as I now find myself most days).

So, if it were me and I was looking for the answers to your questions, I'd try and set up a meeting with the discharge nurse of the respitorary unit of your local hospital.  Chances are he or she will have had some experience with getting an oxygen supply to some pretty bizzare locations for other patients, and even if they can't arrange it for you; they would more than likely be able to point you in the right direction and give you some points of contact.

I was quite impressed at the stance the hospital took regarding me living on a boat.  They were quite insistant that I should return to the boat, being able to live a good quality of life and ensured I had all the bits of kit I needed to maintain that quality of life.  There was never a mention that maybe it was time to think of a different life style.  I was quite impressed with the effort they went to, to understand what it means to live on a canal boat and some of the obstacles we incure, which are different if you live in bricks & motar.

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Once again my thanks to the inputs given.  I have some investigating to do, and the oxy generators sound a good way to go as smaller to use and lighter to lug about. Briefly looking on the net for them they are quite expensive to buy..I don't know if they can be hired and would that work out more expensive in the long run... I think couple of posters suggested I talk in the first instance to the respiratory team as to best way forward.  But having tried before I felt that they didn't fully understand my predicament with a 200 year old system of a canal lock and pulling a heavy cylinder on a trolley around it....hardly a health & safety exercise!!!  Still I need something to carry on boating and it's out there somewhere. So cheers again folks.

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1 hour ago, Bettie Boo said:

I'd try and set up a meeting with the discharge nurse of the respitorary unit of your local hospital.  Chances are he or she will have had some experience with getting an oxygen supply to some pretty bizzare locations for other patients, and even if they can't arrange it for you; they would more than likely be able to point you in the right direction and give you some points of contact.

 

Couldn't agree more**.  They will also be familiar with the OP's specifics regarding his COPD (which is extremely complex) and what the supplemental O2 is for (dyspnoea, hypoxaemia exercise tolerance etc etc).  Only then will the OP know whether it is just 'portable' O2 supplementation that is required or something a bit more substantial on the boat.

** - I am not a doctor but the wife is and all this medical stuff is her opinion (obviously) not mine

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10 minutes ago, Karma Dreams said:

Once again my thanks to the inputs given.  I have some investigating to do, and the oxy generators sound a good way to go as smaller to use and lighter to lug about. Briefly looking on the net for them they are quite expensive to buy..I don't know if they can be hired and would that work out more expensive in the long run... I think couple of posters suggested I talk in the first instance to the respiratory team as to best way forward.  But having tried before I felt that they didn't fully understand my predicament with a 200 year old system of a canal lock and pulling a heavy cylinder on a trolley around it....hardly a health & safety exercise!!!  Still I need something to carry on boating and it's out there somewhere. So cheers again folks.

Sorry, I didn't mean the doctor's or nurses of the respiratory unit, but rather the discharge nurse and/or the Occ Health nurse which cover the respiratory unit.

They will both have experience of installing oxygen supplies to various different locations as well as portable units for various different life styles requirments.

Good luck in the search for the answers your looking for.

Edited by Bettie Boo
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20 hours ago, mross said:

I may be over dramatic but I wanted the OP to be aware that medical oxygen does carry some risks.  Here is a leaflet from BOC where it states that you should not enter a space if the O2 level is 22% or more.  http://www.boconline.co.uk/en/sheq/gas-safety/gas-risks/oxygen-gas-risks/oxygen-gas-risks.html 

another leaflet states that levels as low as 24% are dangerous.  http://www.hse.gov.uk/pubns/indg459.pdf

OMG, we are all doomed :rolleyes:

yes, you are scaremongering.

 

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23 minutes ago, mross said:

19% will lead to impaired judgement; 10% rapid unconsciousness, convulsions and death.

 

We lived at just over 3000ft for 5 years.  At that height the effective O2 level is 18.6%.  No wonder I kept bumping into things!  Shame I'm still doing it now I live at 300ft.  Must be an age thing.

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They say that pilots' vision is impaired above 8,000' cabin altitude ( meaning the air pressure in the cockpit, not the plane's altitude, although they may be the same).  If you live at altitude I think you become acclimated quite quickly.

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1 hour ago, mross said:

19% will lead to impaired judgement; 10% rapid unconsciousness, convulsions and death.

 

Are you sure about the 19%?

According to Wikipedia,  exhaled air given via mouth to mouth resuscitation contains 17% oxygen.

"Efficiency of mouth-to-patient insufflation

Normal atmospheric air contains approximately 21% oxygen when inhaled in. After gaseous exchange has taken place in the lungs, with waste products (notably carbon dioxide) moved from the bloodstream to the lungs, the air being exhaled by humans normally contains around 17% oxygen. This means that the human body utilises only around 19% of the oxygen inhaled, leaving over 80% of the oxygen available in the exhalatory breath.[11]

This means that there is more than enough residual oxygen to be used in the lungs of the patient, which then enters the blood."

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29 minutes ago, cuthound said:

Are you sure about the 19%?

Yes I am.  As a ship's engineer, I had to know about the perils of entering a space deficient in oxygen.  Exhaled air is very good for resuscitation because the CO2 stimulates breathing.  In my company, a tank entry would not proceed if the O2 level was 20% or less.

I no longer have access to my company regs but here is something similar - http://www.standard-club.com/media/24153/AMastersGuidetoEnclosedSpaceEntry.pdf

See the table on page 8

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1 hour ago, mross said:

They say that pilots' vision is impaired above 8,000' cabin altitude ( meaning the air pressure in the cockpit, not the plane's altitude, although they may be the same).  If you live at altitude I think you become acclimated quite quickly.

"They" have obviously never flown above 8000'. Firstly it is a very personal thing, fitness levels, lung disease, age etc all play a part and an individual's tolerance of altitude varies from day to day. At 8000', after a while most people accustomed to life below 1000', will have reduced blood oxygen saturation which has a slight affect on cognitive performance but not on vision in any significant way. Above 13,000' cognitive impariment becomes significant in most people, especially if prolonged. This is why by law, one is allowed to fly up to 10,000' without supplementary oxygen, between 10,000 and 13,000 only for 30 minutes, and not above 13,000 unless you have supplementary oxygen.

People say that altitude hypoxia is very insidious, making you feel euphoric and dysfunctional but unable to realise it, but in my experience provided you are looking out for the symptoms it's pretty obvious. So for example when I was up at 25,000' last year (with a pressure-controlled demand system) I started to fell a little odd and it was obvious I needed more oxygen, so I put the system into emergency mode (which delivers more oxygen) for the remaining climb up to 28,500'. But at no point was my vision impaired in any perceptible way.

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According to the FAA smokers will experience 25% reduction in visual performance at 6,000 feet.  At night any pilot can suffer visual impairment at 5,000 feet.

https://www.faa.gov/pilots/safety/pilotsafetybrochures/media/pilot_vision.pdf 

In passenger aircraft the cabin pressure altitude is normally maintained at 6,000 to 8,000 feet.  So the pilots may have less than optimal vision in the last stages of a flight.

My PPL has lapsed but I still take an interest in these matters.

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45 minutes ago, mross said:

According to the FAA smokers will experience 25% reduction in visual performance at 6,000 feet.  At night any pilot can suffer visual impairment at 5,000 feet.

https://www.faa.gov/pilots/safety/pilotsafetybrochures/media/pilot_vision.pdf 

In passenger aircraft the cabin pressure altitude is normally maintained at 6,000 to 8,000 feet.  So the pilots may have less than optimal vision in the last stages of a flight.

My PPL has lapsed but I still take an interest in these matters.

Stuff put out by the FAA should sometimes be taken with a pinch of salt. Their regulations prescribe use of cannulas above 18,000' - you must use a mask. But recent European research shows this to be an inappropriate regulation and that cannulas are better than ordinary (as opposed to pressurised) masks at high altitude, such as those sold by Mountain High, a major US manufacturer of leisure aviation oxygen systems. The evidence the FAA used to come up with this regulation, many years ago, has been shown to be flawed.

i didn't know this when I went to 28,500', so I used a mask and that is probably why I became a bit hypoxic and had to put the system into emergency mode. I have since always used the cannula and, although I haven't been up to 28,000' again, have found the cannula to be absolutely fine above 18,000'

On the passenger aircraft thing, the cabin altitude is never higher than the actual altitude, so whilst the pilots will have been "soaked" at 6-8000', once they descend and get on approach the cabin pressure will increase significantly such that their sats are likely to be virtually normal for landing. I think the very low relative humidity, and possible contamination with organophosphate from leaky air pressurisation pump seals are likely to be more debilitating.

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@NN thanks, that's all interesting.  How do you, personally, self-assess for hypoxia when euphoria and loss of judgement are early symptoms?  You said earlier that you suffered no loss of visual acuity as far as you could perceive.  Could you have deceived yourself?  Do any glider pilots use these fingertip oximeters?

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